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Beam scanning based on metasurfaces is widely discussed in recent years owing to its high integration, lightweight, and low cost. However, most of the reported beam scanning metasurfaces operate in either transmission or reflection mode. Here, we propose a full-space beam scanning metasurface based on transmission reflection switchable meta-atom and the quadratic phase distribution. As a validation, a metasurface array with 400 units (20 × 20) was experimentally demonstrated. Beam scanning of ± 35 ° was achieved in both transmission mode and reflection mode. A larger scanning angle (± 45 °) was further verified simulatively with a 900-units (30 × 30) array. The method provides an avenue for expanding the space of electromagnetic wave manipulation and may have great potential in wireless communication and radar detection.

Numerous studies have investigated the distribution of methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms and their associations with diseases in China. In this study we conducted a systematic review and meta-analysis of these studies (715 eligible studies in total).Results revealed that the frequencies of the MTHFR C677T and A1298C polymorphisms varied markedly in different areas and ethnicities, and even showed geographical gradients. The MTHFR C677T polymorphism was significantly associated with 42 clinical disorders (p < 0.05), mostly relating to the diseases of circulatory system, birth defects and cancers. The association of the A1298C polymorphism with three diseases (coronary heart disease, breast cancer and neural tube defects fathers) was statistically significant (p < 0.05). However, according to the Venice criteria, only the associations of the C677T polymorphism with breast and ovarian cancers were assessed as having strong epidemiological credibility. This is the first study to provide a comprehensive assessment of the current status and gaps in genetic epidemiological study of the two polymorphisms in China, and its findings may be useful for medical and public health practices. Future studies are warranted to focus on the interactions of MTHFR genes with environmental exposure and with other genes, and to improve their methodological quality and reporting of findings.

An axially displaced monopulse dual-reflector antenna operating at W band is proposed in this study. The antenna configuration consists of a hyperboloid as the subreflector, a combination of series of paraboloids with different focal length as the main reflector and a low-loss sum-and-difference network, which is based on waveguide magic Ts and bent waveguides. Compared with traditional dual-reflector antenna, axial size and weight of this novel antenna can be reduced to a certain extent. Measured results show that the gain is 40.1 dBi, the sidelobe is

Supplemental Digital Content is available in the text, A new method of diagnosing fat embolism (FE) at the molecular level was proposed, and the diagnostic value of adipocyte-specific protein fatty acid-binding protein 4 (Homo sapiens [human]) gene ID = 2167 (FABP4) for FE was preliminarily explored. Eight joint replacement patients, 5 internal medicine patients, and 6 healthy persons were recruited. Serum of internal medicine patients, healthy people, and patients before and 24 hours after joint replacement were taken as study samples. Subcutaneous adipose, intra-articular adipose and intramedullary yellow bone marrow of patients undergoing joint replacement were taken as study samples. The level of FABP4 in the above samples was detected by enzyme-linked immunoassay. Normal distribution was tested. Paired sample T test was used for self-control. Univariate analysis of variance was used for multigroup comparison. There was no significant difference in serum FABP4 level between healthy persons, medical patients, and preoperative patients. The FABP4 level in yellow bone marrow and subcutaneous adipose was significantly higher than that in serum of healthy people, medical patients, and preoperative patients. FABP4 level in the serum after joint replacement was significantly higher than that before joint replacement. FABP4 may be a specific indicator of FE diagnosis, but further studies are needed to confirm its clinical value.

Irregular subarray technology is presented in this paper for wide-angle scanning phased arrays. Based on the exact set cover theory and dancing links algorithm, a solution of the exact partition is developed using different kinds of irregular subarrays. Simulation results show that the irregular subarray architecture exhibits good radiation performances as well as no-sub array architecture.

Several studies have examined the associations of methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase reductase (MTRR) A66G polymorphisms with being overweight/obesity. However, the results are still controversial. We therefore conducted a case-control study (517 cases and 741 controls) in a Chinese Han population and then performed a meta-analysis by combining previous studies (5431 cases and 24,896 controls). In our case-control study, the MTHFR C677T polymorphism was not significantly associated with being overweight/obesity when examining homozygous codominant, heterozygous codominant, dominant, recessive and allelic genetic models. The following meta-analysis confirmed our case-control results. Heterogeneity was minimal in the overall analysis, and sensitivity analyses and publication bias tests indicated that the meta-analytic results were reliable. Similarly, both the case-control study and meta-analysis found no significant association between the MTRR A66G polymorphism and being overweight/obesity. However, sensitivity analyses showed that the associations between the MTRR A66G polymorphism and being overweight/obesity became significant in the dominant, heterozygous codominant and allelic models after excluding our case-control study. The results from our case-control study and meta-analysis suggest that both of the two polymorphisms are not associated with being overweight/obesity. Further large-scale population-based studies, especially for the MTRR A66G polymorphism, are still needed to confirm or refute our findings.

Prior evidence indicates that homocysteine plays a role in the development of metabolic syndrome (MetS). Methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase reductase (MTRR) A66G polymorphisms are common genetic determinants of homocysteine levels. To investigate the associations of the MTHFR C677T and MTRR A66G polymorphisms with MetS, 692 Chinese Han subjects with MetS and 878 controls were recruited. The component traits of MetS and the MTHFR C677T and MTRR A66G genotypes were determined. A significant association was observed between the MTHFR 677T allele and increased risk of MetS, high fasting blood glucose, high waist circumference, and increasing number of MetS components. The MTRR A66G polymorphism was associated with an increased risk of MetS when combined with the MTHFR 677TT genotype, although there was no association found between MetS and MTRR A66G alone. Furthermore, the MTRR 66GG genotype was associated with high fasting blood glucose and triglycerides. Our data suggest that the MTHFR 677T allele may contribute to an increased risk of MetS in the northern Chinese Han population. The MTRR A66G polymorphism is not associated with MetS. However, it may exacerbate the effect of the MTHFR C677T variant alone. Further large prospective population-based studies are required to confirm our findings.

In this article, two novel kinds of focusing elements as reflectors are analyzed and compared. One is the grooved Fresnel zone plate reflector with continuous phase-correcting. The other called subzone paraboloid reflector, has the profile that consists of a series of paraboloids. Their diffraction efficiencies and bandwidths are described. The two elements still preserve the advantages of Fresnel zone plates, namely, low profile, high efficiency, and simple fabrication. Two dual-reflector antennas using the proposed focusing elements as the main reflectors are simulated and the results show that these antennas have good radiation performances. © 2014 Wiley Periodicals, Inc. Int J RF and Microwave CAE 25:101-108, 2015.

Patients with idiopathic pulmonary fibrosis (IPF) have significantly impaired pulmonary diffusion, which may affect the pulmonary concentration of many drugs, including antibiotics. In this study, we compared the difference in pulmonary levofloxacin (LVFX) concentration between patients with normal lung function and IPF. The IPF group included 10 patients with a proven diagnosis of IPF and a diffusing capacity for carbon monoxide ranging from 40% to 70% of predicted values. The control group included 10 patients with normal pulmonary function. Blood and bronchoalveolar lavage fluid (BALF) were taken at 3-3.5 h after fasting. LVFX (500 mg) was administered orally. LVFX concentrations in the serum and BALF were determined using HPLC-MS/MC. The level of LVFX in alveolar epithelial lining fluid (ELF) was calculated using the following formula: LVFX ELF = LVFX BALF × (Urea serum/Urea BALF). No significant differences in age, body weight, height, and calculated creatinine clearance and BALF retrieval rate were observed between groups. LVFX serum concentrations in the IPF and control groups were (5.97 ± 1.28) μg/ml and (6.84 ± 3.43) μg/ml, respectively (P = 0.4727). ELF concentration of LVFX in the control group was (27.81 ± 21.36) μg/ml, while the concentration in the IPF group was (10.17 ± 2.46) μg/ml, less than half of that in the controls (P = 0.0058). The intrapulmonary concentration of LVFX in IPF patients was lower than those with normal lung function. Notably, however, the ELF LVFX concentration following 500 mg once-daily exceeded the MIC90 of common respiratory pathogens. Excellent antibacterial efficacy of LVFX can be expected for IPF patients in the treatment of respiratory tract infections.

Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms are, independently and/or in combination, associated with many disorders. However, data on the combined genotype and haplotype distributions of the 2 polymorphisms in Chinese population were limited. We recruited 13,473 adult women from 9 Chinese provinces, collected buccal cell samples, and determined genotypes, to estimate the combined genotype and haplotype distributions of the MTHFR C677T and A1298C polymorphisms. In the total sample, the 6 common combined genotypes were CT/AA (29.5%), TT/AA (21.9%), CC/AA (15.4%), CC/AC (14.9%), CT/AC (13.7%), and CC/CC (3.4%); the 3 frequent haplotypes were 677T-1298A (43.6%), 677C-1298A (37.9%), and 677C-1298C (17.6%). Importantly, we observed that there were 51 (0.4%) individuals with the CT/CC genotype, 92 (0.7%) with the TT/AC genotype, 17 (0.1%) with the TT/CC genotype, and that the frequency of the 677T-1298C haplotype was 0.9%. In addition, the prevalence of some combined genotypes and haplotypes varied among populations residing in different areas and even showed apparent geographical gradients. Further linkage disequilibrium analysis showed that the D’ and r2 values were 0.883 and 0.143, respectively. In summary, the findings of our study provide further strong evidence that the MTHFR C677T and A1298C polymorphisms are usually in trans and occasionally in cis configurations. The frequencies of mutant genotype combinations were relatively higher in Chinese population than other populations, and showed geographical variations. These baseline data would be useful for future related studies and for developing health management programs.

Background Little is known regarding the interactions of methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase reductase (MTRR) A66G polymorphisms with overweight/obesity on serum lipid profiles. The aim of the current study was to explore interactions between the two polymorphisms and overweight/obesity on four common lipid levels in a Chinese Han population and further to evaluate whether these interactions exhibit gender-specificity. Methods A total of 2239 participants (750 females and 1489 males) were enrolled into this study. The genotypes of the MTHFR C677T and MTRR A66G were determined by a TaqMan assay. Overweight and obesity were defined as a body mass index between 24 and 27.99 and ≥ 28 kg/m2, respectively. The interactions were examined by factorial design covariance analysis, and further multiple comparisons were conducted by Bonferroni correction. Results There was no significant difference in the genotypic and allelic frequencies between females and males (MTHFR 677 T allele: 54.47 % for females and 54.40 % for males; MTRR 66G allele: 24.73 % for females and 24.71 % for males). Interaction between the MTHFR C677T polymorphism and overweight/obesity on serum triglyceride levels, and interaction between the MTRR A66G polymorphism and overweight/obesity on serum high-density lipoprotein cholesterol levels were detected in women (P = 0.015 and P = 0.056, respectively). For female subjects with overweight/obesity, the serum triglyceride levels in MTHFR 677TT genotype [1.09 (0.78–1.50) mmol/L] were significantly higher as compared with MTHFR 677CC genotype [0.90 (0.60–1.15) mmol/L, P = 0.007], and the MTRR 66GG genotype carriers had higher serum high-density lipoprotein cholesterol levels than those with MTRR 66AG genotype (1.46 ± 0.50 vs. 1.19 ± 0.31 mmol/L, P = 0.058). Furthermore, in male subjects with overweight/obesity, the MTHFR 677CT genotype carriers had higher low-density lipoprotein cholesterol levels than those with MTHFR 677TT genotype (2.96 ± 1.07 vs. 2.74 ± 0.88 mmol/L, P = 0.015). Conclusions Our results indicate that there exist interactive effects of the MTHFR C677T and MTRR A66G polymorphisms with overweight/obesity on some lipid traits in Chinese Han population, and the effects were gender-specific.

Hypertension is considered to be the result of genes, environment, and their interactions. Among them age, sex, tobacco use, alcohol consumption, and being overweight/obesity are well documented environmental determinants, and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism is nominated as a potential genetic candidate. However, the synergistic effect of the MTHFR C677T polymorphism with these environmental factors on the risk of hypertension has received little attention. The aim of this study was to explore the associations of the MTHFR C677T polymorphism, environmental factors, and their interactions with hypertension predisposition in a Northern Chinese Han population. A total of 708 participants were enrolled in the study. The genotypes of the MTHFR C677T were determined by a TaqMan assay. We found that participants of an older age, being overweight/obesity, with a smoking habit, drinking habit, or carrying the 677T allele were at an increased risk of hypertension. Additionally, there existed marginally significant interactions of the polymorphism with age and overweight/obesity. However, future large, well-designed studies in Chinese and other populations, as well as mechanistic studies, are still needed to validate our findings, especially considering that the interactions observed in our study were only marginally significant.

Objective Pleural effusion is rarely observed in patients with multiple myeloma (MM). Myeloma cell infiltration or invasion to the pleura is very rare. This study aimed to investigate the clinical characteristics of pleural effusion in patients with MM. Methods We retrospectively reviewed the medical records of patients diagnosed with pleural effusion, MM, and pleural effusion with MM between 2004 and 2014 at Beijing Jishuitan Hospital. The present study included patients with pleural effusion who underwent cytological, bacteriological, biochemical and other testing. The cytopathology of abnormal pleural effusion cells was not diagnostic, thus flow cytometry was performed. MM was defined using the diagnosis standard of NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) 2014 for MM. Results This study included 3,480 pleural effusion patients and 319 MM patients. There were 34 patients with both MM and pleural effusion (17 men and 17 women). The average age was 63 years (range, 48-84 years). Pleural effusion with MM was caused by congestive heart disease, chronic renal failure, hypoalbuminemia, pulmonary infarctions, cirrhosis, pulmonary arterial hypertension, parapneumonic effusion, tuberculous pleural effusion, and myelomatous pleural effusion (MPE). The diagnosis of MPE was confirmed by the detection of myeloma cells in the pleural fluid using flow cytometric analyses. There were only 2 MPE cases in our study. The first MPE case was a woman. The first clinical manifestation was pleural effusion, and the diagnosis was non-secretory MM, DSS stage IIIA (Durie-Salmon staging system); ISS stage I (the International Staging System). The second MPE case was a man who was diagnosed with MM IgA-κ, DSS stage IIIA; ISS stage II. Conclusion The detection rate of MPE was very low. MPE tended to present with yellow exudates and the lack of physical and chemical characteristics. Furthermore, patients with MPE exhibited many yellow nodules on the pleura. These nodules were lobulated and had abundant blood supply. The routine pleural effusion pathological examination had low sensitivity. Flow cytometry may be more useful for improving the detection rate of MPE.

This paper presents the axially displaced ellipse antenna with low profile at W band. The antenna configuration consists of an ellipsoid as the subreflector and a combination of series of paraboloids with different focal lengths, which called subzone paraboloid, as the main reflector to keep low profile. Closed-form design equations are derived using the principles of geometrical optics. Two-dimension finite-difference time-domain method is introduced to obtain the characteristics of subzone paraboloid. CST is implemented to further analyze this antenna. The bandwidth of the antenna can be improved by adjusting the height of each paraboloid of the main reflector. Simulated results show that this antenna exhibits good radiation performance and is suitable for radar and communication system at W band.

Hyperhomocysteinemia (HHcy, total homocysteine concentrations &gt, 15 μmol/L) has been associated with increased risk of many diseases. A systematic review was performed to summarize the prevalence of HHcy in China. We searched multiple international and Chinese scientific databases for relevant literature, and further manually screened reference lists and corresponded with original authors. Pooled prevalence of HHcy was calculated using random effects model. Subgroup analysis, meta-regression and sensitivity analysis were also performed. A total of 36 studies consisting 60,754 subjects (57.3% male, age range, 3–97 years) were finally included. The overall pooled prevalence of HHcy was 27.5%. Geographically, the prevalence was high in north areas, intermediate in central areas, and low in south areas, and was higher in inland versus coastal areas. The prevalence increased with age and was significantly higher in men than in women. Rural residents had a slightly higher HHcy prevalence than urban residents, and the studies conducted during 2006 to 2012 presented a higher HHcy prevalence than those during 1990 to 2005. In summary, the prevalence of HHcy in China is high, particularly in northern populations, the inlanders, males, and the elderly. Homocysteine-lowering strategies are necessary to reduce this highly preventable disorder.

To evaluate the role of surgical lung biopsy (SLB) in the management of diffuse interstitial lung disease (DILD) with no specific diagnosis.We conducted a retrospective analysis of 179 cases with DILD of non-specific diagnosis after non-invasive methods and minimally invasive processes, including bronchoscopy and CT-guided lung biopsy, were performed SLB at Peking Union Medical College Hospital between 2006 and 2012. Patient demographics, surgical approach, number and site of biopsies, post-operative complications and postoperative pathological diagnosis and treatment were analyzed.Of 179 cases, there were 91 males (50.8%) and 88 females (49.2%), with a median age of 47.3 years (range 16-76). There were 6 cases(3.4%) who were younger than 20 years and 25 cases(14%) older than 60 years. From 2006 to 2012, every year there were 16 case (8.9%), 17 cases(9.5%), 19 cases (10.6%), 44 cases (24.6%), 33 cases(18.4%), 31 cases (17.3%) and 19 cases (10.6%) respectively. The total median hospital stay was 33.4 days (range 6-76) and the mean postoperative stay was 18.6 days (range 2-56). The mean duration for chest drainage was 3.2 days (range 2-18). Among them, 150 cases were arranged with video-assisted thoracoscopy surgery (VATS) and 29 cases were arranged with minithoracotomy. The number of biopsies taken was ranged from one to four and there were 126 cases (70.4%) had more than one biopsy. The biopsy was performed in left lingular lobe (54 cases/30.2%), left natural upper lobe (16 cases/8.9%), left inferior basal segments (56 cases/31.3%), right upper lobe (30 cases/16.7%), right meddle lobe (40case/22.3%) and right inferior basal segments (56 case/31.3%) respectively. Definitive pathological diagnosis was reached in 103 cases (57.5%), diagnosis was reached after combination of pathological, clinical and radiological manifestations in 32 cases (17.9%) and there were 44 cases (24.6%) could not achieved diagnosis even after the SLB. Chronic extrinsic allergic alveolitis was the most common diagnosis (33/24.4%), following nonspecific interstitial pneumonia (27/20%) for the 135 cases with a definite diagnosis. Among 179 cases, there were 114 cases had a change in their treatment following the results of SLB. There were 16 cases had a fever after surgery and antibiotics were administrated for eleven of them. Other complication were included delayed wound healing (10 days after surgery, 6 cases), thoracic hemorrhage (5 cases), chest tube re-indwelling because of pneumothorax (4 cases), delayed weaning of ventilator (3 days after surgery, 4 cases), respiratory failure (3 cases), and thoracic infection (2 cases). There were two cases died within 30 days following surgery because of respiratory failure.Most of the DILD patients who were arranged with SLB were young and middle-aged cases. The left lingular lobe, right meddle lobe and both inferior lobes were the preferred biopsy sites. The results of biopsy surgery could provides a diagnosis for most of the DILD patients and could modulate the treatment for more than half of them. Fever and delayed wound healing were the major complications. The SLB related mortality was low. SLB was suggested to the undiagnosed DILD patients.

To determine the beneficial effects and mechanisms of fasudil, a selective ROCK inhibitor, on bleomycin-induced pulmonary fibrosis in mice and to determine the effects and mechanisms of fasudil on the biological behaviors in NIH3T3 mouse fibroblast cell line.The BPF model was induced by a single dosage of 2.5 mg/kg bleomycin intratracheal injection in mice and fasudil intraperitoneal injection was given to the mice. The fibrosis degree was determined pathologically by using the Ashcroft scoring method and biochemically by hydroxyproline assay in lung tissue. NIH3T3 mouse fibroblast cell line was cultured in vitro and fasudil was given to the cell. The proliferation activity in NIH3T3 cells were detected by MTT assay and flat colony forming experiment. The migration activity in NIH3T3 cells were detected by scratch test and transwell chamber experiment. The expression of CyclinD1, MMP2 and TIMP1 mRNA in NIH3T3 cells was detected by RT-PCR. The expression of CyclinD1, MMP2 and TIMP1 protein and the level of MYPT1 phosphorylation in NIH3T3 cells was detected by Western blot.Compare to the mice administrated by bleomycin, the Ashcroft score and hydroxyproline content were significantly decreased in the mice administered fasudil. Administration of fasudil can reduce the ability of proliferation and migration in a dose-dependent manner in NIH3T3 cells. The effect of fasudil was possibly related to increase the production of TIMP1 and decrease the production of CyclinD1 and MMP2.Administration of fasudil can attenuate pulmonary fibrosis both in vivo and in vitro. These findings suggest that fasudil may be a potential therapeutic candidate for the treatment of pulmonary fibrosis.

Using the transverse Hertz vector potentials, vector analyses of linearly and circularly polarized Bessel beams of arbitrary orders are presented in this paper. Expressions for the electric and magnetic fields of vector Bessel beams in free space that are rigorous solutions to the vector Helmholtz equation are derived. Their respective time averaged energy density and Poynting vector are also obtained, in order to exhibit their non-diffracting properties. Polarization patterns and magnitude profiles with different parameters are displayed. Particular emphasis is placed on the cases where the ratio of wave number over its transverse component k/kt approximately equals to one and largely exceeds it, which corresponding to the nonparaxial and paraxial condition, respectively. These results allow us to recognize that the vector Bessel beams exhibit new and important features, compared with the scalar fields.

To the Editor: Sarcoidosis is a systemic granulomatous disorder that most commonly affects young or middle-aged women. Sarcoidosis can coexist with a wide range of autoimmune disorders and other granulomatous diseases.[1] Here, we describe a rare case of sarcoidosis coexisting with another granulomatous autoimmune disease, Takayasu arteritis (TA). A 29-year-old woman was admitted to Department of Respiratory Medicine, Peking Union Medical College Hospital, because of aggravating shortness of breath and occasional exertional chest pain in July 2013. Since December 2011, she had suffered from a dry cough accompanied by low fever and exertional dyspnea. Laboratory results showed elevated erythrocyte sedimentation rate (ESR) (82 mm/h) and C-reactive protein (CRP) (46.4 mg/L). Antinuclear antibodies (ANA), antineutrophil cytoplasmic antibody (ANCA), and serum angiotensin converting enzyme (sACE) were all negative. Chest computed tomography (CT) showed subpleural nodules, with both hilar and mediastinal lymphadenopathy [Figure 1a]. Biopsy of the bronchial mucosa showed epithelioid cell granulomas without necrosis. She was diagnosed with tuberculosis (TB) in the local hospital. Isoniazid, Refampacin, Ethambutol plus Pyrazinamide had been prescribed to her for 6 months. But fever and cough continued, while repeated bronchoscopy and mucosal biopsy was consistent with epithelioid granulomas without necrosis in August 2012. She was diagnosed with sarcoidosis and was given prednisone in September 2012. She had no discomfort until June 2013. Her low-grade fever, dry cough, exertional dyspnea, and occasional chest pain recurred and she was admitted to our hospital. Her physical examination was unremarkable, except a slightly elevated heart rate of about 100 beats/min. Pulmonary function test, echocardiography, and repeated ECG during episodes of chest pain were normal. Holter monitoring showed no arrhythmias. Bronchoscopy showed scattered nodules in the left and right inferior basal bronchial mucosa. Bronchoalveolar lavage fliud (BALF) analysis showed a lymphocytic cellular pattern, with 16% lymphocytes and CD4/CD8 ratio of 1.0. Histology of the mucosal biopsy was still consistent with sarcoidosis [Figure 1b]. Tuberculosis polymerase chain reaction (TB-PCR) of the mucosa was negative. A positron emission tomography (PET)-CT scan was performed. The results showed thickening and hypermetabolism of the aortic wall, from the initial segment of ascending aorta to the aortic arch [Figure 1c]. These findings were considered typical for the diagnosis of TA, which was further confirmed by aortic CT angiography [CTA, Figure 1d]. The patient was then given prednisone 1 mg∙ kg-1∙ d-1 and methotrexate (MTX) 15 mg per week. Two weeks later, all of her discomfort was resolved. Prednisone was then tapered with 5 mg per week after 5 weeks of treatment. Currently, she is taking prednisone 15 mg and MTX 15 mg per week, and she remains free of symptoms and has normal ESR and CRP. Figure 1 (a) The chest CT on 8 February 2012 showed hilar and mediastinal lymphadenopathy. (b) (HE staining, Original magnification ×100) Biopsy of the bronchial mucosa showed epithelioid cell granulomas without necrosis, which is consistent with sarcoidosis. ... Both sarcoidosis and TA are granulomatous diseases which usually affect young women. Concurrence of sarcoidosis and TA has been previously reported only in few cases.[2,3] Most of them are females under the age of 40. Large vessel manifestations, mainly inflammation and narrowing of the aortic arch and bifurcations, were usually preceded by sarcoidosis. With the earlier cases reported, it is suggested that TA and sarcoidosis may be related diseases.[3] As TA is too rare to indicate that the reported concurrence with sarcoidosis is merely governed by chance. Several common features had been found among these patients:[2] (a) Usually sarcoidosis preceded TA; (b) the time between the diagnosis of sarcoidosis and that of TA was several years (eight or more) in most of these patients; (c) the aorta and/or its major branches were affected; (d) 50% of the patients had uveitis; and (e) all patients responded well to glucocorticoid treatment. The association of TA and sarcoidosis raises a number of questions as whether there is a possible etiologic link between these two disease entities. Or can TA or TA-like granulomatous vasculitis be considered in fact a complication of sarcoidosis? Till now, there was no definite answer to these questions. It appears reasonably important to check for large vessel inflammation in these patients. Since angiography is not a reliable method to assess for vascular inflammation, PET scan seems to be a better choice to look for these changes.

Sarcoidosis is a systemic granulomatous disease, which is thought to result from an aberrant immune response. CD4+ T lymphocytes play an important role in the development of granulomas. Previously, the immunopathogenesis of sarcoidosis was focused on Th1/Th2 disturbances. The aim of this study was to evaluate the balance between newer CD4+ T lymphocytes, i.e., Treg and Th17 cells. In our studies, a decrease in Treg cells and an increase in Th17 cells were observed in the peripheral blood and BALF of sarcoidosis patients. A significant increase in the Th17/Treg cell ratio was observed in sarcoidosis patients. After treatment with prednisone, the expression of Foxp3 mRNA was elevated in the peripheral blood, and expression of (ROR)γt mRNA showed a downward trend. These findings suggest that sarcoidosis is associated with an imbalance between Th17 and Treg cells in peripheral blood and BALF. Therefore, targeting the cytokines that affect the Th17/Treg ratio could provide a new promising therapy for pulmonary sarcoidosis.

Background Methylenetetrahydrofolate reductase (MTHFR) C677T, A1298C and methionine synthase reductase (MTRR) A66G polymorphisms are important genetic determinants for homocysteine (Hcy) levels, and are associated with several disorders. These polymorphisms are heterogeneously distributed worldwide. Our objective was to explore the geographical distributions of these polymorphisms in China. Methodologies 15357 healthy adults were recruited from 10 regions. Buccal samples were collected and genomic DNA was isolated. Genotyping was performed using the fluorogenic 5′-nuclease assay. Principal Findings The prevalence of the three polymorphisms among different populations from China varied significantly and showed apparent geographical gradients. For MTHFR C677T, the frequencies of the 677T allele and the 677TT genotype were significantly higher among northern populations and ranged from the lowest values (24.0% and 6.4%, respectively) in Hainan (southern) to the highest values (63.1% and 40.8%, respectively) in Shandong (northern). For MTHFR A1298C, the 1298C allele and the 1298CC genotype frequencies were significantly higher among southern populations and increased from low values (13.1% and 1.4%, respectively) in Shandong to high values (25.7% and 6.7%, respectively) in Hainan. For A66G, the 66G allele and the 66GG genotype frequencies increased from lower values (23.7% and 5.4%, respectively) in Shandong to higher values (29.2% and 8.6%, respectively) in Hainan. The overall frequency of the 677T allele, 677TT genotype, 1298C allele, 1298CC genotype, 66G allele and 66GG genotype in the Chinese Han population was 45.2%, 23.2%, 18.6%, 3.9%, 25.7%, and 6.6%, respectively. No gender differences were found in the prevalence of both the MTHFR C677T and MTRR A66G polymorphisms. Conclusions This study indicates that there are marked geographical variations in the prevalence of the three polymorphisms among Chinese Han populations. Our baseline data may be useful for future researches in related fields.

Objectives Pulmonary sarcoidosis is an immune-mediated disease, and some patients can be effectively treated with corticosteroids. However, nearly half of all sarcoidosis patients relapse after corticosteroid withdrawal. Different subsets of CD4+ helper T cells participate in the immunopathogenesis of sarcoidosis. Thus, the aims of our study were to investigate whether the circulating subsets of CD4+ helper T cells were associated with sarcoidosis relapse and with its remission after retreatment. Additionally, we identified a useful biomarker for predicting the relapse and remission of sarcoidosis patients. Methods Forty-two patients were enrolled in the present study who had previously been diagnosed with pulmonary sarcoidosis and treated with corticosteroids. The patients were allocated into either a stable group if they exhibited sustained remission (n = 22) or a relapse group if they experienced clinical or radiological recurrence after treatment withdrawal (n = 20). Peripheral blood cells were collected from these patients and analyzed to determine the frequencies of subsets of circulating CD4+ helper T cells by flow cytometry. The patients in the relapse group were retreated with corticosteroids and immunosuppressive agents and were then reevaluated to determine the frequencies of dynamic subsets of circulating CD4+ helper T cells after remission. Results The frequencies of circulating Tregs were significantly increased concomitant with a decrease in the circulating Th17 cell frequency in the relapsed patients compared with the stable patients. The Treg/Th17 ratio was negatively correlated with sarcoidosis activity and was sensitive to retreatment. In addition, the percentage of isolated CD45RO+Ki67+ Tregs was higher in the patients who were stable and in those who recovered after retreatment than in those who relapsed. Conclusions An imbalance between Tregs and Th17 cells is associated with pulmonary sarcoidosis relapse after corticosteroid withdrawal. The circulating Treg/Th17 ratio could serve as an alternative marker for monitoring pulmonary sarcoidosis relapse after the end of corticosteroid treatment and for rapidly predicting the response to retreatment.

Background Pirfenidone (PFD) is a novel antifibrotic agent approved for patients with pulmonary fibrosis. However, there are concerns regarding toxicity of the drug. In this meta-analysis, we analyzed the adverse events (AEs) of PFD for the treatment of pulmonary fibrosis. Methods We performed a systematic search of PubMed, Embase, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials for trials published between January 1999 and October 2011. Data extracted from literature were analyzed with Review manager 5.0.24. Results The results of six randomized controlled trials (1073 participants) revealed that the number of individuals who discontinued PFD therapy was significantly higher than patients receiving placebo. The PFD group had a significantly higher rate of gastrointestinal (nausea, dyspepsia, diarrhea, and anorexia), neurological (dizziness and fatigue), and dermatological (photosensitivity and rash) AEs compared to the placebo group. Conclusions PFD used for the treatment of pulmonary fibrosis is not so safe or well-tolerated. Notably, gastrointestinal, neurological and dermatological adverse effects were more common in patients receiving PFD therapy, and therefore appropriate precaution is needed.

The mechanisms underlying the pathogenesis of idiopathic pulmonary fibrosis (IPF) involve multiple pathways, such as inflammation, epithelial mesenchymal transition, coagulation, oxidative stress, and developmental processes. The small GTPase, RhoA, and its target protein, Rho-kinase (ROCK), may interact with other signaling pathways known to contribute to pulmonary fibrosis. This study aimed to determine the beneficial effects and mechanisms of fasudil, a selective ROCK inhibitor, on bleomycin-induced pulmonary fibrosis in mice. Our results showed that the Aschcroft score and hydroxyproline content of the bleomycin-treated mouse lung decreased in response to fasudil treatment. The number of infiltrated inflammatory cells in the bronchoalveolar lavage fluid (BALF) was attenuated by fasudil. In addition, fasudil reduced the production of transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), alpha-smooth muscle actin (α-SMA), and plasminogen activator inhibitor-1 (PAI-1) mRNA and protein expression in bleomycin-induced pulmonary fibrosis. These findings suggest that fasudil may be a potential therapeutic candidate for the treatment of pulmonary fibrosis.

Two novel types of continuous Fresnel Diffraction Mirror (FDM) are designed and applied to a double-reflector monopulse antenna at Ka band. One FDM is a metal reflector, which the profile consists of a seris of hyperboloids, and the other is a metal reflector filled with dielectric, which will alter the eccentricity of the hyperboloids and has higher diffraction efficiency. These two monopulse antennas both perform high gain, low sidelobe and have a lower profile compared with traditional Cassegrain Monopulse Antennas.

In order to consummate the management of bank paper, a new algorithm which can recognize the areas of paper tape in bundle of paper money is presented. Image segmentation is used to divide the image into several sub-blocks. Specifically, image entropy is computed in each sub-block. Experimental in different algorithms, including color training algorithm and the median filter and edge detection algorithm, demonstrates its real-time, effectiveness and robustness.